RWE-009 - PATTERNS OF USING ANTIDIABETIC MEDICATIONS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS IN KOREA WITH AND WITHOUT CHRONIC KIDNEY DISEASES: MULTI-INSTITUTIONAL, REAL-WORLD DATA ANALYSIS USING THE OMOP COMMON DATA MODEL.

S. Joo¹, S. Park¹, Y. Choi¹, S. Yang¹, J. Cha², Y. Kim², S. Rhee¹, H. Hwang¹, D. Chang³, D. Kim¹, C. Kim¹, S. Rhie⁴, E. Chung¹; ¹Kyung Hee University, Seoul, Republic of Korea, ²Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea, ³The Catholic University of Korea, Catholic University of Korea Yeouido Saint Mary's Hospital, Seoul, Republic of Korea, ⁴Ewha Womans University, Seoul, Republic of Korea.

Background: Patients with chronic kidney disease (CKD) are at an increased risk for adverse reactions of many drugs including antidiabetic drugs (ADDs). The objective of this study was to characterize the pattern of using ADDs in patients with CKD using real-world data.

Methods: In this retrospective, observational study, data from the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) were utilized. Patients who received ≥ 1 dose of ADDs from 2010 to 2020 were identified in 3 large OMOP CDM databases. Patients with CKD stages 3 to 5 or glomerular filtration rate < 60 mL/min/1.73 m2 were defined as the CKD group; the non-CKD group was those who did not meet the criteria for the CKD group. Data analyses were performed using ATLAS 2.7.6 or R 4.0.3 to compare patterns of using ADDs between the CKD and non-CKD group.

Results: Among a total of 66,868 patients who took ≥ 1 dose of ADDs, 16,206 and 50,662 patients were in the CKD and non-CKD group. The majority of patients were between 60 and 70 years of age. The most frequently used ADD was insulins (62.87%) in the CKD group and metformin (66.33%) in the non-CKD group, respectively. Although metformin was the most commonly used ADD in CKD stage 3a (67.99%), its use was significantly decreased as the CKD stage progressed (49.20% in stage 5; P < 0.05). In patients with CKD stages worse than 3b, the prevalence of using insulin and dipeptidyl peptidase-4 inhibitors (DPP4i) was significantly higher compared to that of metformin (P < 0.05), contributing to the higher prevalence of insulin and DPP4i use in the CKD group than in the non-CKD group (P < 0.05).

Conclusion: The stage and the presence of CKD significantly impacts the pattern of using ADDs. Future studies are warranted to evaluate the real-world safety profile of ADDs in patients with CKD at different stages.

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